Many Individuals Hospitalized for COVID-19 Still Experience Musculoskeletal Pain 1 Year Later

Long-term musculoskeletal pain was relatively common among individuals who were hospitalized with COVID-19.

A multicenter cohort study found that post-COVID musculoskeletal (MSK) pain remains prevalent 1 year after hospitalization. These findings were published in the journal Pain.

The LONG-COVID-EXP-CM study included data on patients hospitalized with acute SARS-CoV-2 at 5 urban hospitals in Spain between March 20 to June 30, 2020 (N=7150). A random subset of 400 patients from each hospital were invited to participate in this analysis.

Gender, pain history, and COVID-19 symptoms were significant predictors for long-term post-COVID musculoskeletal pain in this cohort.

Participants (n=1969) were contacted by telephone on 2 occasions and evaluated for their symptoms of pain and by the Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) instruments.

The participants were 46.5% women aged mean 61 (standard deviation [SD], 16) years. The average time from hospitalization to first and second follow-ups was 8.0 (SD, 1.5) and 13.2 (SD, 1.5) months, respectively. Only 1593 participants participated in both follow-ups.

Over a third of participants (37.8%) reported MSK pain during follow-up. Individuals with lingering MSK pain had pre-existing pain, more COVID-19 symptoms at hospital admission, longer hospital stays, and more symptoms of anxiety and depression at follow-up (all P <.001).

Among the patients reporting post-COVID pain who had pre-existing pain (53.2%), 29.1% said their post-COVID MSK pain was different than before COVID-19.

There was a decreasing trend in the prevalence of MSK pain from hospital admission to the first and second follow-up.

At 1 year, MSK pain was located in lower extremities (23.4%), widespread (18%), thoracic chest (16.2%), upper extremities (9.1%), wrist or elbow (6.3%), cervical spine (5.7%), knee (5.3%), lumbar (5%), shoulder (4%), and hip (2.5%).

Significant predictors for pain included MSK pain at first follow-up (adjusted odds ratio [aOR], 11.022; 95% CI, 8.493-14.305; P <.01), headache at admission (aOR, 2.278; 95% CI, 1.622-3.199; P <.01), female gender (aOR, 1.593; 95% CI, 1.148-2.211; P <.01), previous MSK pain (aOR, 1.591; 95% CI, 1.221-2.074; P <.01), myalgias at admission (aOR, 1.371; 95% CI, 1.032-1.821; P <.01), and hospital length of stay (aOR, 1.013; 95% CI, 1.000-1.025; P <.01).

This study was limited by restricting the study population to individuals who had been hospitalized. It remains unclear whether these findings are generalizable for individuals who had less severe disease.

In conclusion, this cohort found that long-term post-COVID MSK pain was relatively common among individuals who had been hospitalized with acute SARS-CoV-2 1 year previously. Gender, pain history, and COVID-19 symptoms were significant predictors for long-term post-COVID MSK pain.


Fernández-de-las-Peñas C, Cancela-Cilleruelo I, Moro-López-Menchero P, et al. Exploring the trajectory curve of long-term musculoskeletal post-COVID pain symptoms in hospitalized COVID-19 survivors: a multicenter study. Pain. Published online June 13, 2022. doi:10.1097/j.pain.0000000000002718